脐尿管癌诊断治疗及预后分析(附36例报告)  

Diagnosis,treatment and prognosis of urachal cancer (36 cases report)

作　　者：侯飓[1] 耿秀霞 庄建[3] 宋飞[1] 赵谦[1] 郭环宇[1] 黄伟[1] 韩增箎[1] 邵建国[1] 

机构地区：[1]山东中医药大学第二附属医院泌尿外科,济南250001 [2]河南台前县疾病预防控制中心 [3]山东中医药大学

出　　处：《现代泌尿生殖肿瘤杂志》2014年第4期210-213,共4页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的总结脐尿管癌的临床特征,提高对脐尿管癌的诊治水平。方法回顾性分析36例脐尿管癌的临床资料。结果男26例,女10例。平均年龄（50.0±2.5）岁。肉眼血尿31例,血尿伴尿频、尿急5例,血尿中位时间22d。尿中有黏液者16例。肿瘤直径平均（5.0±1.0）cm。盆腔淋巴结转移3例。TNM分期：T221例,T312例,T43例。临床分级：G118例,G213例,G35例。均行扩大性膀胱部分切除术。术后病理诊断黏液性腺癌28例,非黏液腺癌混合癌5例（含肠型、印戒细胞亚型）,乳头状腺癌3例。术后膀胱内灌注表阿霉素治疗25例。36例患者均获随访,随访1-8年,平均2.5年。术后1年生存率为50%（18/36）,5年生存率为19.44%（7/36）。T2期患者的5年生存率为23.81%（5/21）,T3期患者的5年生存率为16.67%（2/12）。结论脐尿管癌不容易被早期发现和诊断。血尿是脐尿管癌的最常见症状。扩大性膀胱切除术为标准手术方式。脐尿管癌预后较差。Objective Summary the clinical features of urachal cancer to improve the level of diagnosis and treatment. Methods Clinical data of 36 patients with urachal cancer were retrospectively reviewed. Results Male 26 cases,female 10 cases.Average age was（50.0±2.5）years old.31 cases had naked-eye hematuria,5cases had hematuria with urinary frequency-urgency,median numbers of hematuria time was 3.5months.16 cases had mucilage in urine.Average diameter of tumor was（5.0±1.0）cm.3cases had pelvic lymph node shift.TNM installments：21cases had stage T2,12 had stage T3 and 3had T4.Clinical classification：18cases had G1,13 had G2and 5had G3.All cases were given expand-bladder-partial-nephrectomy.Pathological diagnosis after surgery：Mucinous adenocarcinoma was 28 cases,non-mucinous adenocarcinoma was 5cases（intestinal and signet ring cell subtypes）and papillary adenocarcinoma was 3cases.25 cases had intravesical chemotherapy with epirubicin after surgery.Follow-up 36 cases,follow-up time was 1-8years,average time was 2.5years.One-year survival rate after surgery was 50%（18/36）,five-years survival rate was19.44%（7/36）.Five-years survival rate of T2 was 23.81%（5/21）,five-years survival rate of T3 was 16.67%（2/12）. Conclusions Early diagnosis is difficult for urachal cancer.Hematuria is the most common symptom.Expand-bladder-partial-nephrectomy is standard surgical way.Prognosis of urachal cancer is relatively poor.

关 键 词：脐尿管肿瘤 诊断 治疗 预后 

分 类 号：R737.1[医药卫生—肿瘤]